Leake, Phyllis H.
Leake, Phyllis H. is an individual health care provider with primary practice located at 130 Carbonton Rd , Sanford NC 27330-4009. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Leake, Phyllis H. can be contacted via phone (919) 774-6521.Contact Information
Primary practice address
130 Carbonton Rd
Sanford NC 27330-4009
Phone: (919) 774-6521
Fax: (919) 776-6179
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C000926 | North Carolina |
Profile Details
| NPI number | 1104831528 |
|---|---|
| LBN Legal business name | Leake, Phyllis H. |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Mar 25th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104831528 | NPPES |
| North Carolina | MEDICAID | 6003578 |
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